Prostate cancer patients zapped with electricity in new treatment

"The electricity is so powerful they have to be paralysed while we're doing it or they would just jump off the table."

This was St Vincent's Private Hospital urologist Phillip Stricker, speaking of an emerging treatment for prostate cancer that involves zapping the tumour with more electricity than a bolt of lightning.

A new, less-invasive procedure for getting rid of prostate cancer being performed at St Vincent's Hospital by Professor Phillip Stricker.
Credit:Steven Siewert

Patient Rob Gunn, 65, was unconscious on the operating table, legs aloft, with four needles framing the site of the cancer.

Over the next 10 minutes, 90 pulses of electricity passed between the needles, exposing each centimetre of tissue to up to 1500 volts. By the end, the lesion had completely disappeared.

"You can't underestimate the potential of this technology," Professor Stricker said. "It's going to save a lot of people from having unnecessary surgery."

The technology is known as the "nanoknife".

Traditional methods of treating prostate cancer, which attack the whole prostate with radiation or surgery, often come at the cost of the patient's continence or erectile function.

Cancer is being overdiagnosed, the question is: what to do about it?
Credit:Steven Siewert

The nanoknife targets only the site of the cancer, destroying the cells of the cancer without the structures surrounding it, including the erectile and urethral nerves.

Urologists in three countries are trialling the technology on patients who have a single site of localised prostate cancer that needs more treatment than active surveillance.

The "nanoknife" technique targets only the lesion, framed with four needles in the scrotum.Credit:Steven Siewert

About 15 to 20 per cent of prostate cancer patients are suitable for the treatment.

But Professor Stricker is the first to publish his results on cancer outcomes with a study in Prostate Cancer and Prostatic Diseases, demonstrating that in a study of 25 patients, in 76 per cent of cases the cancer had not returned after eight months.

None of them developed incontinence or impotence.

Urological Society of Australia and New Zealand president Mark Frydenberg said he was pleased Australia was at the forefront of prostate research, but it was early days to be claiming victory.

"This is the first study anywhere in the world that has identified any pathological outcomes from the treatment and we're talking about a relatively small number of patients, so it's a little hard to be jumping to conclusions," Professor Frydenberg said.

"Really, the success of a treatment depends on long-term outcomes with regard to both safety and cancer outcomes and we don't really have either of those."

Neither does the operation come cheap.

Still in experimental days, it does not attract a Medicare rebate or private health insurance subsidy.

Mr Gunn paid about $30,000 including time off work and travel costs. His medical expenses were just under $15,000. But going into the operation, he could not stop smiling.

"This is really, really good," he said. "This is a fantastic alternative to having a prostate removed."

Correction: This story has been changed to more accurately reflect the medical cost breakdown.